Spotting Skin Cancer

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The American Cancer Society estimates 3.5 million skin cancers are diagnosed each year. That’s more than all other cancers combined. And that’s only non-melanoma skin cancers (melanoma is the most aggressive—and deadliest—kind of skin cancer).

To avoid skin cancer, you’d basically have to avoid the sun. And as a society, we like the glowing, sun-kissed look! It gives the impression that someone is healthy and robust. But the truth is, tanned skin is damaged skin. And that damage can add up very quickly, leading to wrinkles, freckles, moles, and possibly even skin cancer.

What causes skin cancer and who is at risk?

Skin cancer is most commonly caused by extended ultraviolet light exposure and genetics. “The genetic predisposition is seen in people who have Cancer Prone Skin, or CPS,” explained Charles E. Crutchfield, III, MD, a clinical professor of dermatology at the University of Minnesota Medical School. “These are patients with very fair skin, red or blonde hair, blue or green eyes, freckles, and a family history of skin cancer.”

Those at risk because of extended sun exposure are people who spend a lot of time outdoors, like lifeguards, roofers, or anyone with a job or activity that involves extended hours in sunlight. Also, people who have experienced multiple chronic blistering sunburns are at increased risk. Other factors that can cause skin cancer include certain genetic disorders, exposure to toxins (including cigarette smoke), radiation therapy, or immune deficiencies.

What are the warning signs of skin cancer and what should I do about them?

• BCC is the most common kind of skin cancer; it starts in the top layer of your skin and is typically found on areas most exposed to sunlight, like the ears, face, and scalp. According to the American Cancer Society, BCCs can appear as “raised, pink or red, translucent, shiny, pearly bumps that may bleed after a minor injury.”

• SCC (Squamous Cell Carcinoma) is the second most common skin cancer. It also starts in the top layer of the skin (epidermis) and is found in the same areas as basal cell, but this type of cancer typically forms in people who are 60 and older. SCCs can also begin in areas that have been exposed to radiation—such as X-rays—or cancer-causing chemicals (like tobacco). According to the Skin Cancer Foundation, SCCs can appear as “scaly red patches, open sores, elevated growths with a central depression, or warts; they may crust or bleed.”

• Melanoma is the rarest form of skin cancer and the deadliest. It forms in the part of the skin that produces pigment (melanocytes) and can appear anywhere on the body. The standard for recognizing melanoma is the acronym: ABCDE: asymmetry, border, color, diameter, and evolving.

What do I do if I suspect something?

“Years ago, there was a marketing campaign by the American Academy of Dermatology that said simply, ‘See spot. See spot change. See a dermatologist,’” said Dr. Crutchfield. “The best way of finding out if you have skin cancer is by having a lesion evaluated by a board-certified dermatologist.” Even if you don’t have a lesion, you should get an annual evaluation of your skin, moles, and freckles.

Two diagnostic tools being used by specialists today to detect possible skin cancers include epiluminescence microscopy and the FDA-approved computer vision system called Melafind. Using 10 different wavelengths of light, Melafind can quickly find and detect a spot on your skin that is questionable and determine if that spot should be biopsied. “The bottom line is if you have a suspicious mole, don’t sit on it, see a dermatologist,” Dr. Crutchfield said.

What should I do to protect myself?

The efficacy of sunscreen use is still controversial. However, most dermatologists recommend applying it multiple times a day, particularly between 10 a.m. and 2 p.m., if you’re going to be outside. The American Cancer Society recommends using a broad-spectrum sunscreen (which protects against UVA and UVB rays) with at least SPF 30 that hasn’t expired (sunscreens expire after two to three years). Apply generously 30 minutes before sun exposure and reapply at least every two hours, more depending on activity, levels of perspiration, and/or swimming. For the record, SPF protects against UVB rays, not UVA.

Harry Glassman, MD, founder of Skin Clinical, said he tells patients to look for sunscreens that contain micronized zinc (because this ingredient protects against both UVA and UVB rays). “One in five Americans will be diagnosed with skin cancer [this year],” he said. “The incidence is rising at an alarming rate. However, sunscreen is not a waste of time or effort. The incidence would likely be higher without sunscreens.”

Beyond sunscreen, Dr. Crutchfield recommends considering clothing made with fabrics that that are lightweight and very tightly weaved to block out the sun. “It’s like wearing a personal umbrella that doesn’t have to be reapplied every hour,” he said.

What about AK (actinic keratosis)?

Actinic keratosis is an early-stage, pre-cancerous patch of scaly, thick, or “crust-like” skin that usually develops after years of repeated sun exposure. If left untreated, they can develop into squamous cell carcinoma, a common type of skin cancer. If your dermatologist can check it out early, AK can be treated before it becomes skin cancer. Common types of treatments include liquid nitrogen, topical photodynamic therapy, lasers, and surgical techniques to remove the affected area.

Get Your Faux Glow On

Rimmel London Instant Tan Sun Shimmer Wash Off Gel, $9

“Protecting skin from the sun is a must, but that doesn’t mean you can’t achieve a sun-kissed glow the healthy way,” said Rodan and Fields Skin Care consultant, Josephine Dries, out of Rochester Hills, MI. She suggests finding a quality lightweight, oil-free, mess-free sunless tanning lotion or foam that contains the active ingredient dihydroxyacetone, or DHA, and will apply easily and dry quickly. “Also, look for a sunless tanner that contains antioxidant vitamins A, C, and E, and protects skin from free radical damage,” she said.

If you want quality, look for sunless tanners sold in spas or department stores. If the idea of orange knees or uneven color worries you, then let the professionals handle it with airbrush tanning. Color develops within 6 to 24 hours and lasts about five to seven days. Keep in mind, a fake tan does not protect you against the sun.